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Erectile Dysfunction (Impotence)

Definition

Erectile Dysfunction is the inability to get or keep an erection firm enough for sexual intercourse. ED can be a total inability to achieve an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections.

According to recent studies, erectile dysfunction (ED) is highly prevalent across white, black and Hispanic populations in the United States. White men age 70 years and older, as well as those suffering from diabetes, were shown to be at greater risk for developing ED, though severe lower urinary tract symptoms were shown to be ED related in black men. Odds decreased in black men who exercised or had good partner relationships.

Alternative Names

ED; Impotence

Causes

ED is most often caused by health problems that require treatment to help prevent more serious complications. Some of the problems that can cause ED are:

Symptoms

Exams and Tests

A person’s medical and sexual histories help define the degree and nature of ED. The medical history can disclose diseases that lead to ED, and a simple recounting of sexual activity might identify problems with sexual desire, erection, ejaculation, or orgasm. Use of certain prescription or illegal drugs can suggest a chemical cause because drug effects are a frequent cause of ED.

Physical Examination

A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to physical touch, a problem in the nervous system may be the cause.

Laboratory Tests
Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes.

Other Tests
Monitoring erections that occur during sleep-nocturnal erections-can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than a psychological cause.

Psychosocial Examination
A psychosocial examination, using an interview and a questionnaire, can reveal psychological factors. A man’s sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

Treatments

Lifestyle changes-including exercising more, quitting smoking, losing weight, and cutting back on alcohol-may solve the problem. If you have made these changes and still have erection problems, your doctor can offer a number of other treatments.

Treatment may include:

Counseling. Even though most cases of ED have a physical cause, counseling can help couples deal with the emotional effects.

Oral medication. Your doctor may prescribe a pill to treat ED. Current brands include Viagra, Levitra, and Cialis. These drugs work by increasing blood flow to the penis. Do not take any of these drugs if you are taking nitrates, a type of heart medicine.

Injection. Medicines injected into the shaft of the penis or inserted into the tip of the penis usually cause an erection within minutes.

Vacuum device. A vacuum tube inserted over the penis can create an erection. As air is pumped out of the tube, the penis expands and blood flows into it. After the tube is removed, a specially designed rubber band is placed at the base of the penis to keep the blood from flowing out.

Penile implant. If other options fail, a surgeon can implant a device into the penis that inflates or can be straightened to create an erection.

Natural Remedies

(BlackDoctor.org) — Learn more about the cause of erectile dysfunction to overcome this sensitive condition. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

• Quit smoking
Men who smoke have an increased ED risk

• Check out Asian ginseng
900 mg of a concentrated herbal extract two or three times a day may improve libido and ability to maintain erection

• Give ginkgo a go
Take 240 mg a day of a standardized herbal extract to increase blood flow to the penis

• Try yohimbe and DHEA
With the help of a doctor experienced in these treatments, take an herbal extract of yohimbe containing 15 to 30 mg a day of yohimbine to increase blood flow, or 50 mg a day of the supplement dehydroepiandrosterone to improve hormone levels

• Get a checkup
ED can be caused by some diseases and may be a side effect of certain medications

• Consider counseling
Psychological issues can be a cause, or an effect, of ED

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full erectile dysfunction article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.